Posts Tagged ‘Community’

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NHS called to invest in IT for integrated care

Monday, January 23rd, 2012

The director of Care Informatics Consulting has urged the NHS to invest in IT systems, stating that information sharing has the potential to greatly improve patient care, but this can only come as a result of co-ordination and data access.

Julian Todd asserts that an integrated care model is generally believed to lead to better patient outcomes, satisfaction and cost efficiency. He states however that much debate arises when discussing how to fund, organise and commission IT systems.

Todd states that “lean thinking” states that in order to eliminate waste, managers must look at the overall system and understand the processes which deliver value. For care services, that means understanding care pathways, service user experiences, causes of demand on the system and options for ways of meeting those needs.

Long term conditions (LTCs) are thought to be the most significant factor in driving IT need as they cause a disproportionate demand for care services. “Case management” has often been cited as a method to potentially improve the delivery of care for patients with LTCs.

Effective case management, Todd says, requires shared information about risk, assessments and care plans. Patients and their carers need easy access to their records and their plan, plus information on self care, support groups, entitlement, service options and quality.

Todd states that one of the cheapest, quicker and most effective ways to allow access to patient information is to have a robust recording system supplemented by portal technology to encourage patients to actively participate in and contribute towards their care.

“GP-led commissioning has the potential to shift attention and perspective away from large care organisations like NHS Trusts and councils towards a whole systems view centred on service users and communities. Information is the glue to bind all the pieces of integrated care” Todd said.

If the focus is to be shifted out of acute settings and into the community, Trusts must take the initiative to implement systems that will best support this change. Therapy Manager is an Electronic Patient Record (EPR) system which enables clinicians to create secure offline databases of patient records for easy community travel. Patient data and activity can be recorded on-the-go and quickly uploaded back to the main database when the clinicians are back on site. The “Therapies Viewer” also enables staff from all specialties to view the information contained within the system, ensuring clarity around treatment.

Original Source The Guardian

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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North Bristol to move away from the “outdated hospital model”

Wednesday, January 4th, 2012

North Bristol NHS Trust has announced a proposal to close one of its acute hospitals as part of a reconfiguration of its health services, instead changing to a new hospital model and the creation of a “health and social care campus”.

The proposed “campus” will instead include a community hospital and nursing home owned by the private sector, a new GP surgery, “extra care” housing, and outpatient services for patients with long-term conditions. It is thought that the changes will affect around 500,000 people living in Bristol and South Gloucester.

The announcement comes as Mike Farrar, Head of the NHS Confederation, last week said that at least one in four inpatients could be better looked after in the community or their own homes. He deemed the current NHS an “outdated hospital model of care”, saying that whilst in some cases acute settings are vital, they should not be seen as the only method of providing care. “We should be concentrating on shifting resources into community services” he said.

Chief Executive of the Trust, Ruth Brunt, asserts that 27% of patients currently in acute hospitals in the Trust are there unnecessarily. These patients represent a significant cost to the Trust, as Brunt states that “hi-tech” treatment in an acute setting is “extraordinarily expensive”, and less effective for those who are seen to be improving.

The plans for the health and social campus include extra care housing, where patients can move to in order to continue living in their homes while receiving enhanced health and social care, and outpatient clinics for older people and those with long-term conditions. It is assumed as a result that 40% of outpatient activity will move to community facilities. The proposed community hospital will have diagnostic facilities that will provide blood tests, x-rays, scans and echocardiograms, and physiotherapy, dietetics and occupational therapy. Brunt states that this will place the focus of treatment around reablement and rehabilitation, and actively suppot people to return to independent living.

It is believed that the approach will ultimately lead to cheaper and more intermediate care for patients. In the current NHS climate, with £20 billion of savings having to be made be 2016, it is thought that alternatives to acute hospitals will be welcomed by be the government.

Candace Imison, Deputy Director of Policy at the King’s Fund believes the trust has a good chance of success because its reconfiguration involves just two sites, and asserts that it could work in other areas.

Original Source The Guardian

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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Case Management: a future strategy for the NHS?

Monday, December 12th, 2011

A report has been published stating the benefits of “case management”, an internationally accepted approach to healthcare which is thought could prove highly effective and cost-efficient.

Nick Goodwin, a senior fellow at The King’s Fund who co-wrote the “Case management: what it is and how it can best be implemented” report says that case management has a central role to play in meeting the needs of older people and those with complex chronic illnesses.

Goodwin states that in order to meet the challenges of an ageing population and a broad shift in demographic and disease status, the NHS must re-asses the ways in which care is delivered. A better co-ordinated and integrated set of services around the needs of individual patients and service users is thought to be essential.

Case management is described as a “targeted” approach to care that involves case finding, assessment, care planning, and care co-ordination. The focus is placed on proactive community-based care as opposed to acute care, with care targeted at those individuals with the greatest risk of an emergency admission. The key aims of case management are to improve care experiences and outcomes whilst reducing expensive hospital utilisation.

Previous implementations of case management have however met mixed reviews. Despite leading to improvements in outcomes and the patient experience, the approach has not led to significant cost savings. “It has come to represent an additional expense on the system rather than a solution to financial imperatives” states Goodwin.

Goodwin however asserts that there is ample evidence to suggest that case management can prove effective, stating that the failures of previous attempts have been a reflection of bad management. Failure of teams to take accountability of patient care, leading to confusion on the patient’s part about how their care is managed, has been cited amongst the reason for failures. Furthermore, targeting of patients to receive intensive case management can be problematic as incorrect implementation can result in the wrong patients receiving the wrong types of care.

Case management can only be part of a larger system change, as access to good community services is essential. Clinicians working in community settings also need to be granted access to the same tools as those working in an acute setting, and be supported as best possible to do their job.

Whilst Goodwin states that case management has a central part to play in the future NHS, it needs careful application if the benefits are to be realised.

“There needs to be a fundamental rethink of current incentives within the health system that serve to reinforce investment and expenditure in acute hospitals rather than tackling the root cause of the issue, beginning with the at-risk individual living at home” Goodwin said.
If the focus is to be shifted out of acute settings and into the community, Trusts must take the initiative to implement systems that will best support this change. Therapy Manager is an Electronic Patient Record (EPR) system which enables clinicians to create secure offline databases of patient records for easy community travel. Patient data and activity can be recorded on-the-go and quickly uploaded back to the main database when the clinicians are back on site. Effective utilisation of mobile technologies coupled with an EPR can help to ensure that clinicians are provided with the tools to perform to the highest standards, which could help to support process redesign, reduce costs and ultimately improve the patient experience.

Original Source The Guardian

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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Social Care Cuts affect Community Physio, SLT and OT services

Thursday, November 10th, 2011

A investigation from the Pulse has revealed that dramatic cuts to social care budgets are placing practices under mounting pressure, with GP’s being forced to refer patients into hospital care due to the lack of capacity in primary and community services.

The services most affected are council-funded physiotherapy, speech and language therapy, elderly care and mental health services following an average 4.7% cut in council social care budgets across England. With a reduction in these services, GP practises are often left with an increased demand which they cannot cope with.

It also appears that key services for vulnerable patients including legal aid, welfare services and public health campaigns are also being hit.

Manchester City Council this month become the latest authority to announce millions of pounds of social care cuts, with services for the elderly, disabled, mentally ill and victims of domestic violence hit by a fresh round of cuts totalling £8.6 million.

Dr Hamish Meldrum, GP and chair of the British Medical Association stated cuts to services like home help and support for carers of vulnerable patients were already having a significant knock-on effect on other services. He cites examples of hospital admissions increasing due to a reduction in resources being made available, also implying that some patients are being treated in an inappropriate or geographically distant setting.

It is believed that cuts to public health campaigns and recreational activities will ultimately have a long-term impact on the NHS. “The squeeze on social care is adding pressure on the health system” Dr Meldrum said.

Where the cuts are being made:

1. Gateshead Council to limit elderly care to ‘critical only’ services to save an estimated £10m
2. Leeds Mental health crisis centre closed earlier this year, as council faced £90m spending cuts
3. Nottinghamshire Citizens Advice Bureau services report 60% cut in council funding
4. South London Connexions service offering employment support decommissioned across six boroughs, with one also axing speech and language therapy, physiotherapy and occupational therapist posts

The resounding feeling from GP’s is that is a result of fewer community services, vulnerable patients such as the elderly are finding it increasingly more difficult to be cared for in their own homes or a setting which is convenient for them.

Whilst community services are essential for ensuring that patient choice is fully catered for, departments may often have difficulties in justifying their contribution both financially and with regard to patient outcomes, meaning that they can often be the first target of cuts. Trusts with domiciliary care services could therefore seek to implement an Electronic Patient Record (EPR) system like Therapy Manager which enables clinicians to create secure offline databases of patient records for easy community travel. Effective utilisation of mobile technologies coupled with an EPR can help to ensure that clinicians are provided with the tools to perform to the highest standards, which will help to streamline working processes, reduce costs and ultimately improve the patient experience. Activity recording and reporting on performance and finance can also highlight exactly where costs are being incurred, ensuring that cuts are only targeted to the relevant areas.

Original Source Pulse Today

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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NHS Telehealth Opportunities Missed

Wednesday, October 19th, 2011

A new report by Audit Scotland has revealed that Telehealth systems which have the potential to save the health service hundreds of thousands of pounds are being under utilised by the NHS.

Telehealth services are designed to provide remote electronic healthcare to patients with long term conditions such as diabetes or heart conditions. Patients are provided with devices such as blood sugar monitors to that can alert clinicians working in the community if readings fall outside of acceptable normal level.

The report asserts that with appropriate targeting, Telehealth can offer the potential to help NHS Trusts to deliver a range of clinical services more efficiently and effectively. In order to achieve this, Trusts are therefore advised to consider the use of Telehealth when introducing or redesigning clinical services.

Lack of uptake of Telehealth services have been attributed to the low profile the system currently has in the NHS. Furthermore, barriers in funding are thought to have restricted and will continue to restrict development of Telehealth in the future.

Potential savings from the implementation of Telehealth are though to be significant. In the instance of patients with Chronic Obstructive Pulmonary Disease (COPD), home monitoring of patients is thought to save around £1,000 per patient per year, mostly through reducing admissions to hospital and increasing capacity for community and domiciliary care staff.

Robert Black, Auditor General for Scotland said that Telehealth could help to provide a range of services efficiently and effectively, especially in the current NHS climate which faces serious pressures from the ageing population and the increasing number of patients suffering from long-term health conditions. In areas where Telehealth has been implemented, Black asserted that clinicians and patients had generally responded positively.

Original Source Pulse Today

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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Posted in Community | No Comments »

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